深入了解支持或阻碍自治的支持性协商的环境因素和机制,以及此类协商的结果。
我们根据RAMESES指南使用现实主义综合程序进行了系统评价。在PubMed中进行了搜索,Embase,PsycINFO和Cinahl从成立到2019年3月使用搜索词:\'自治\'和\'支持\'和\'咨询\'或\'沟通\'和\'干预\'。审查过程包括论文选择,质量评估,数据提取的全文阅读由两名研究人员独立进行。
在2792篇文章中,18符合我们的纳入标准。影响自治支持性咨询的上下文因素是:工作组织和专业人员的态度。AS的总体支持机制是建立关系。此外,决策过程的每个阶段似乎都需要支持机制来满足患者的特定心理需求。AS的结果是更高水平的患者健康。
自治支持性咨询在各种环境下工作,加上产生有利结果的机制,建立关系,花时间和探索病人的需求似乎是最重要的。
我们的审查结果有助于专业人士反思他们的自主性支持性咨询技能,这可以改善他们的自主性支持行为。
Gaining insight into contextual factors and mechanisms supporting or hindering autonomy supportive consultation and into outcomes of such consultations.
We conducted a systematic
review using the realist synthesis procedure according to RAMESES guideline. A search was performed in PubMed, Embase, PsycINFO and Cinahl from inception to March 2019 using the search terms: \'autonomy\' AND \'support\' AND \'consultation\' OR \'communication\' AND \'intervention\'. The
review process including paper selection, quality assessment, full text reading for data-extraction was conducted by two researchers independently.
Of 2792 articles, 18 met our inclusion criteria. Contextual factors influencing an autonomy supportive consultation were: work organization and the attitude of professionals. An overarching supporting mechanism for AS was relationship building. In addition, each phase of the decision-making process seems to need supporting mechanisms fulfilling patients \'specific psychological needs in that phase. The outcome of AS is higher levels of patient well-being.
Autonomy supportive consultation works under various contexts coupled with mechanisms that give rise to favourable-outcomes, of which relationship building, taking time and exploring patients\' needs seem the most important.
The results of our
review facilitate professionals to reflect on their autonomy supportive consultation skills, which could improve their autonomy supportive behaviour.